Cole Joanna C M, Olkkola Michelle, Zarrin Haley E, Berger Kelsey, Moldenhauer Julie S
J Obstet Gynecol Neonatal Nurs. 2018 Jan;47(1):84-93. doi: 10.1016/j.jogn.2017.04.131. Epub 2017 Jun 21.
To describe the implementation of a nurse-led project to screen parents for depression and traumatic stress in the postpartum period after visiting their newborns in the NICU.
A standardized universal mental health postpartum screening and referral protocol was developed for parents of high-risk neonates.
SETTING/LOCAL PROBLEM: The project occurred at the Garbose Family Special Delivery Unit, the world's first obstetrics unit housed within a pediatric hospital serving healthy women who give birth to newborns with prenatally diagnosed fetal anomalies. Parents of neonates admitted to the NICU are at greater risk to develop postpartum psychological distress; therefore, early identification is critical.
A total of 1,327 participants were screened, including 725 women who gave birth to live newborns at the Garbose Family Special Delivery Unit and 602 fathers.
INTERVENTION/MEASUREMENTS: Obstetric nurses asked parents to complete a screening tool that assessed their psychological risk in the postpartum period. A system for mental health triage and referral was available for parents with elevated scores.
Overall monthly screening procedure compliance rates were high (96.5% mothers and 79.6% fathers). Women (5.5%, n = 40) and men (5.5%, n = 33) showed high risk for traumatic stress, and 35.9% (n = 260) of women and 9.5% (n = 57) of men showed elevated risk for major depression in the imediate postpartum period.
Incorporating the screening process into routine nursing practice with immediate mental health triage and referral made the program feasible. The risk factors identified add to the growing knowledge about parents of newborns in the NICU.
描述一项由护士主导的项目的实施情况,该项目旨在对在新生儿重症监护病房(NICU)看望过新生儿的产后父母进行抑郁和创伤应激筛查。
为高危新生儿的父母制定了标准化的通用心理健康产后筛查和转诊方案。
背景/当地问题:该项目在加尔博斯家庭特殊分娩单元开展,这是世界上首个设在儿科医院内的产科单元,为分娩产前诊断有胎儿异常新生儿的健康女性提供服务。入住NICU的新生儿父母产后发生心理困扰的风险更高;因此,早期识别至关重要。
共筛查了1327名参与者,包括在加尔博斯家庭特殊分娩单元产下活产新生儿的725名女性和602名父亲。
干预措施/测量方法:产科护士要求父母完成一份评估其产后心理风险的筛查工具。为得分较高的父母提供了心理健康分诊和转诊系统。
总体每月筛查程序依从率较高(母亲为96.5%,父亲为79.6%)。女性(5.5%,n = 40)和男性(5.5%,n = 33)表现出创伤应激的高风险,35.9%(n = 260)的女性和9.5%(n = 57)的男性在产后即刻表现出重度抑郁的风险升高。
将筛查过程纳入常规护理实践,并立即进行心理健康分诊和转诊,使该项目可行。所确定的风险因素增加了对NICU中新生儿父母的认识。